June 17, 2017

US: As opioid panel meets, some say action, not study, is needed

Weeks before the presidential election, at a packed rally in New Hampshire, Donald J. Trump recounted the story of a young woman and her boyfriend who had fatally overdosed within a year of each other. He promised not just a border wall to keep drugs out, but also more access to treatment.

“We’re going to take care of it,” he said of the opioid addiction epidemic, which has disproportionately hit states that were crucial to his election victory. “What’s taking so long?”

Five months into his term, though, President Trump has enthusiastically supported a health care bill that would deeply cut the Medicaid program that has provided treatment to thousands of addicted Americans. He has yet to fill the nation’s top public health and drug policy jobs. And while he has appointed a bipartisan commission on the opioid crisis, which held its first official meeting on Friday, it remains to be seen how much attention the panel can command from Mr. Trump’s turbulent administration.

Some addiction specialists say that waiting for a commission’s recommendations when hundreds of people are dying each week — and when countless groups around the country have studied the issue already — is wasting time. What is really needed, the specialists say, is the type of concerted, emergency action that public health officials have used to fight outbreaks of infectious diseases.

“There really isn’t anything this commission is going to figure out that we don’t know already,” said Dr. Andrew Kolodny, who directs opioid policy research at Brandeis University’s Heller School for Social Policy and Management. “What we need is an enormous federal investment in expanding access to addiction treatment, and for the different federal agencies that have a piece of this problem to be working in a coordinated fashion.”

Many experts, including Dr. Kolodny, say they believe that former President Barack Obama was also slow and, until the end of his tenure, ineffective at addressing the opioid problem. Some think his administration was so focused on rolling out the Affordable Care Act that it overlooked the public health crisis that was unfolding in the meantime.

“It would not be hard for Trump to do better than Obama on the opioid crisis,” Dr. Kolodny said.

The opioid commission’s first meeting was attended by Jared Kushner, Mr. Trump’s son-in-law and senior adviser; Kellyanne Conway, the White House counselor; and Tom Price, the health and human services secretary. Several members said the threat to Medicaid expansion was among their top concerns.

“It is the elephant in the room,” said Patrick Kennedy, the former Democratic congressman from Rhode Island, who has had struggles with addiction. “It is the largest provider of coverage for people with mental illness and addiction in this country, so we have to mention the fact that any repeal of Medicaid is a repeal of coverage we currently have out there.”

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Weeks before the presidential election, at a packed rally in New Hampshire, Donald J. Trump recounted the story of a young woman and her boyfriend who had fatally overdosed within a year of each other. He promised not just a border wall to keep drugs out, but also more access to treatment.

“We’re going to take care of it,” he said of the opioid addiction epidemic, which has disproportionately hit states that were crucial to his election victory. “What’s taking so long?”

Five months into his term, though, President Trump has enthusiastically supported a health care bill that would deeply cut the Medicaid program that has provided treatment to thousands of addicted Americans. He has yet to fill the nation’s top public health and drug policy jobs. And while he has appointed a bipartisan commission on the opioid crisis, which held its first official meeting on Friday, it remains to be seen how much attention the panel can command from Mr. Trump’s turbulent administration.

Some addiction specialists say that waiting for a commission’s recommendations when hundreds of people are dying each week — and when countless groups around the country have studied the issue already — is wasting time. What is really needed, the specialists say, is the type of concerted, emergency action that public health officials have used to fight outbreaks of infectious diseases.

“There really isn’t anything this commission is going to figure out that we don’t know already,” said Dr. Andrew Kolodny, who directs opioid policy research at Brandeis University’s Heller School for Social Policy and Management. “What we need is an enormous federal investment in expanding access to addiction treatment, and for the different federal agencies that have a piece of this problem to be working in a coordinated fashion.”

Many experts, including Dr. Kolodny, say they believe that former President Barack Obama was also slow and, until the end of his tenure, ineffective at addressing the opioid problem. Some think his administration was so focused on rolling out the Affordable Care Act that it overlooked the public health crisis that was unfolding in the meantime.

“It would not be hard for Trump to do better than Obama on the opioid crisis,” Dr. Kolodny said.

The opioid commission’s first meeting was attended by Jared Kushner, Mr. Trump’s son-in-law and senior adviser; Kellyanne Conway, the White House counselor; and Tom Price, the health and human services secretary. Several members said the threat to Medicaid expansion was among their top concerns.

“It is the elephant in the room,” said Patrick Kennedy, the former Democratic congressman from Rhode Island, who has had struggles with addiction. “It is the largest provider of coverage for people with mental illness and addiction in this country, so we have to mention the fact that any repeal of Medicaid is a repeal of coverage we currently have out there.”